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Determination of effective half-life of 131I in patients with differentiated thyroid carcinoma: comparison of cystatin C and creatinine-based estimation of renal function

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Abstract

Purpose

Renal function and effective half-life (t1/2,eff) of I-131 have not been fully elucidated in patients undergoing radioiodine therapy (RAIT) for differentiated thyroid cancer (DTC). Aim of the present analysis was to evaluate the potential of cystatin C-based estimated glomerular filtration rate (eGFRCysC) in comparison to conventional creatinine (eGFRCrea) and to verify which methods to determine t1/2,eff are most accurate to predict t1/2,eff.

Methods

Forty-eight patients receiving whole-body I-131-scintigraphy were included. eGFRCysC was compared to eGFRCrea with regard to accuracy of t1/2,eff prediction. Three different methods (i.e. blood-based, gamma camera-based and probe-based) and two protocols with either three (short period,SP; up to 42 h) or four (long period,LP; up to 114 h) time points were compared using the Akaike’s information criterion.

Results

The eGFRCysC measurement is more likely than eGFRCrea in predicting the t1/2,eff. High correlation coefficients were found between t1/2,eff assessed by gamma camera and probe measurements and blood-based determination revealed lower values. Patients with normal eGFR showed higher values of t1/2,eff of LP compared to SP.

Conclusions

eGFRCysC should be included in further study protocols. As camera and probe measurements lead to almost superimposable results, one of the methods is expendable. Blood-based results of t1/2,eff were lower, presumably due to unspecific iodine retention, whereas the lower correlation with renal function may be caused by individual differences in intestinal iodine resorption. SP-protocols up to 42 h after I-131 administration are sufficient to determine t1/2,eff. Further studies are necessary for specific recommendations regarding I-131 activity reduction during RAIT in patients with DTC and renal insufficiency.

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Acknowledgements

Dr. Ernesta Palombo-Kinne is gratefully acknowledged for language assistance with this manuscript. Dominik Driesch is gratefully acknowledged for statistical analyses.

Funding

This study was funded by the intramural grants of the Jena University Hospital only.

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Authors and Affiliations

  1. Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany

    Martin Freesmeyer, Falk Gühne, Christian Kühnel, Thomas Opfermann, Thomas Winkens & Anke Werner

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  1. Martin Freesmeyer
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  2. Falk Gühne
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Correspondence to Martin Freesmeyer.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Freesmeyer, M., Gühne, F., Kühnel, C. et al. Determination of effective half-life of 131I in patients with differentiated thyroid carcinoma: comparison of cystatin C and creatinine-based estimation of renal function. Endocrine 63, 554–562 (2019). https://doi.org/10.1007/s12020-018-1800-4

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  • DOI: https://doi.org/10.1007/s12020-018-1800-4

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